Jun-Qiang Yin(1,2), Yi-Wei Fu(1), Zhen-Hua Gao(3), Chang-Ye Zou(1), Xian-Biao Xie(1), Bo Wang(1), Zhi-Hai Zhong(4), Gang Huang(1), Jing-Nan Shen(1,2).
(1)Dept of Orthopedic Oncology, The First Affiliated Hospital of Sun Yat-Sen Univ, Guangzhou, China. (2)Dept of Musculoskeletal Oncology, Guangdong Provincial Key Laboratory of Orthopedics & Traumatology, Guangzhou, China. (3)Dept of Radiology, The First Affiliated Hospital of Sun Yat-Sen Univ, Guangzhou, China. (4)Dept of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-Sen Univ, Guangzhou, China.
Publication
Neurosurgery
Summary
To assess the efficacy and safety of sandwich isolation surgery on the local control of progressive desmoid tumors involving neurovascular bundles. A total of 27 patients with progressive desmoid tumors at extremities involving neurovascular bundles who received surgery at our hospital between August 2014 and August 2018 were identified. A total of 13 patients received sandwich isolation surgery, in which R2 resection was performed in neurovasculature-involving regions, and a biomaterial patch was used to envelop involved neurovascular structures and isolate residual tumors. A total of 14 patients received traditional surgery, which included tumor resection without isolation procedure. In sandwich isolation group, tumor progressions and local recurrences occurred in 3 patients outside the isolated neurovasculature-involving regions. However, no progressions or recurrences occurred in any patients in the isolated neurovasculature-involving regions where R2 resection was performed. Sandwich isolation surgery group and traditional surgery group shared similar baseline clinical characteristics. The estimated 3-yr event-free survival rate was 76.9% after sandwich isolation surgery, and 32.7% after traditional surgery (P = .025). Patients who received sandwich isolation surgery were less likely to have local recurrence (hazard ratio: 0.257, P = .040). No complications were noted except intermittent mild pain in operative regions (2 cases). Sandwich isolation surgery is effective and safe for local control of desmoid tumors involving neurovascular bundles.
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